HomeMy WebLinkAbout04-07-78 (2)
RCC-72 (~-681
COMMONWEAL TH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLlCA TION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
*~
DATE
January
, 1979
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE,
Application is hereby mode for consent to the transfer of the following securities of 0 Pennsylvania
Corporation or a National Banking Associolion located in Pennsylvania:
(a) 1600 sha. (b) Cotm:lOnwea1th National Bank (c) Connnon
(NOTE: In describing securities enter in (a). ab Ole, either the number of shores of stock or the face amount of
registered bonds, in (b). the nome of the issuing compo~y and in (c) the class of stock or the stated interest rote
and maturity dote of registered bonds.)
ISSUED ON see reverse side ,and having 0 TOTAL MARKET VALUE OF S 52,000.00
(Dote)
os of the dote of death of the decedent,
Charles G. Stone
March 28, 1978
, on
(t-lame of Deecdent)
(Dote of death)
who was late of
519 Warren Street
Cumberland
Penna.
Lemoyne
(Post Office)
(County)
(State)
(Street and Number)
The securities ore registered os follows:
Charles G. Stone
(t-lome or names in which eertificatcs ore registered)
~
EXECUTOR )
310 Bridge Street, New Cumberland, Pa. 17070
Olar1es H. Stone
(Nome)
(Address)
NAME OF APPLICANT Charles H. Stone
-------31U-Bridge Street
ADDRESS OF APPLICANT New Cumberland, Penna.
17070
COUNTY FILE NUMBER
21-78-174
BUREAU FILE NUMBER SIGNA TUR E OF APPLICANT
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLlCA TlON, iT WILL NOT BE
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES '?7 9
DA TE <tz.
I hereby consent 10 the transfer of the above securities now registered in the nome of the aforesaid
r9?(
Decedent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which
the property of said Decedent is mode subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521,
os amended and the Act of June 15, 1961, P.L. 373, os amended. This is also in accordance with the provisions
of the Act of April 9, 1929, P.L. 343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
above-named Decedent.
~
I~~
the Secretory of Revenue
(S~?clll.hlit Ml~(~J\N1~ulf*Y)\
RiGISITR OF WIU3
(THle) l.._~.L:;.U 12~1JXty)